Funchal Central Hospital & Madeira’s Medical Care – A Blogger’s Experience

Last Sunday for me was my worst nightmare come true. A real health emergency, my own! … something I had often thought about, but dreaded having to face.

Without going into too many details about my own health, on Saturday morning I was doing someone a good turn, and felt something go in my back (the mind may boggle here, but please don’t let it!). I knew straight away that was my weekend was written off, but it happens, and a day or two of rest normally does the trick. I had a ticket to go and watch the the Nacional v Sporting game that afternoon, so that was my biggest disappointment.

Anyway, come Saturday night I was in agony. My leg was almost paralised, my back was on fire, and to get to the loo involved sliding along the floor. Needless to say sleep was hard to come by, and by 6am on Sunday morning I realised my options had run out. I slid around the house gathering some things and got dressed and made that dreaded 112 call at 7am. Neither the first or second telephone operator spoke any English, but I am sufficiently able now to cope with that in the local dialect. The fire brigade (ambulance driver) rang 5 minutes later for directions, and within 10 minutes of the first call they had arrived, bringing a wheelchair as requested. With just a five minute ride to the local health centre, it was all off to a good start … if you can call agony a good start! And I was the first and only patient … even better. A quick chat with the duty doctor and it was down with the pants and in with the needle. There must of been 10 staff, including cleaners, even at that time of the morning. They were all very amused by the fact that I chose to sit on the floor (for reasons of comfort), one person pointing out that floor was a dirty place to sit … perhaps a surprising comment as she was the hospital cleaner. Anyway, after waiting 40 minutes or so, the injection had had no effect, so I was whisked back into the ambulance and off to Funchal Central Hospital accident and emergency department (or the equivalent of). The ambulance drivers and staff at Ribeira Brava were excellent, and nothing but praise up until arriving at FCH.

You will probably remember from a week or so ago I reported about the new computerised patient management system in FCH was causing some problems, and combined with high flu levels, the hospital was struggling, with some low priority patients waiting all day to be seen. But I had no need to worry, as having been transferred to another wheelchair by the ambulance crew, I was wheeled around to ‘triage’ and was seen within 5 minutes by the triage nurse. I was given the white sticker which was stuck on my shirt, and then wheeled around to the Orthopaedics (the A & E equivalent) department and put in a waiting area alone. First in line I thought great … pain relief just a few minutes away. For those who don’t remember, ‘green stickers’ are for higher priority patients, but as it happens that day they had run out of green stickers, so everyone had white, and those with higher priority had their sticker swiped with a yellow highlighter pen. Now these stickers are supposed to prioritise patients and provide security control for the hospital, but they in fact did neither, and instead gave the wearer a false sense of expectation about their health problem rating and hospital security. I spent around 6 hours without any sticker at all after a nurse took mine off. As for patient prioritising, the stickers seemed pretty meaningless, as the A & E staff worked from a handwritten list of names, which was added to when someone new came along. So if for example you were sent to X-ray by the doctor, it seemed that you then went to the back of the queue for the follow-up consultation.

Anyway, my dream of being first in the queue was soon dashed, as hospital in-patients were wheeled into A & E on their beds and in wheelchairs, and it was about an hour and a half before it was eventually my turn. I was then taken to see the one and only duty doctor, who told me I would need to go to X-ray before going any further. I begged to have some medication to help with the pain before I went, and he obliged with a drip medicine which took over an hour to get into me, but unfortunately had no effect whatsoever, and just delayed my trip to X-ray. 

It was probably around midday when I went into X-ray, and that was very impressive with automated scanners flying around all over the room, but even so they were having trouble accommodating me as I was unable to leave my wheelchair and stand up straight. OK, up until this point I was still pretty impressed with how the day had gone so far, with lesser waits than I had expected, but still with expectations of being either admitted or sent home within a couple of hours, and maybe even getting a late lunch, as I had nothing so far that day. But that’s when it all started going wrong.

I was wheeled back from X-ray to A & E, to find a lot of new patients had arrived, and I was now at the back of the queue to be seen by the doctor. There were as many foreigners there as locals, mostly with twisted ankles and knocks from walking trips (or so it seemed judging by the big boots they were mostly wearing).

The doctor and his assistant were the only ones I came across all day who spoke any English. That was helpful as my sparse and broken Portuguese would have faired pretty badly in such important and technical conversations. Although the ambulance driver who later took me home also spoke English.

Digressing again for a moment, going to hospital for whatever reason is always a depressing affair, unless you work there, and one thing patients and visitors can take a little comfort in is the nurses, particularly and traditionally for men. I have to say that I was disappointed on this score to find that nurses, orderlies, and other staff were dressed in pastel green or blue, depending on status, and their uniforms of creased loose fitting jackets and trousers were very disappointing in the nurses uniform sense, and totally spoilt the one possible highlight of the day.  

Anyway, after a long wait I eventually got back to see the doctor again, probably around 3pm. He showed me my X-ray and gave a diagnosis, and then sent me off to sit under another painkilling drip which lasted an hour or more, and unfortunately that again had no effect whatsoever. So back in to the doctor again for an injection into the rear end, and this time it did start to work and some partial relief was very very welcome. When I told the doctors assistant, he said OK, now we just need to get you a prescription and we are finished. He had already explained that their objective was to relieve the immediate pain, decide on the medicine needed, and get me discharged. Admission to the hospital was not a consideration in any circumstances, even though I explained I had no care for me back at home. He told me that the injection I had been given would be effective for UP TO 8 hours, which was quite critical to me getting home after getting to a pharmacy, and going straight to bed. I figured that as long as the pain relief lasted the full 8 hours, I had until midnight at the latest to get into bed at home having taken my prescribed medicine. That was not to be the way it worked out however.

I remember at about 6.30pm sitting in my wheelchair looking at my watch and thinking I am so hungry. I had been on the go since 7am, and nothing to eat or drink all day so far, but I was thinking that was just the way it worked, and I would have to just grin and bear it. Of course, had I not been in a wheelchair, and afraid of missing my next slot, that somewhat limited my options to go and seek refreshment myself. I could have easily left over two hours earlier, I wa
s just waiting for that bit of paper I needed to take to the pharmacy. The place was pretty busy by now, and I tuned into a group conversation from some dissatisfied patients who thought they had been waiting too long and were unhappy with the prioritising system and people getting seen out of turn. My opportunity to chip in arose, and I proudly informed them that I had been there since 9am (at least 3 hours longer than anyone else still remaining) and had not even had a glass of water so far that day. Stunned silence and disbelieving expressions ensued, but it must of sunk in somewhere, because it must have been mentioned to a member of staff, as within half an hour I was presented with a bowl of lukewarm and pretty tasteless vegetable soup. Nether-the-less I devoured it in seconds, grateful for anything at that point.

At around 6pm the customary cackling old woman arrived, strapped to her trolley-bed. At first people found her amusing, as did I, as she cackled non stop at full volume. The nurses tried numerous times to get her to shut up, to no avail, and after a couple of hours subjected to that the general feeling of depression was increased for all. She was still in full flow when I left 5 hours after she came in. She, like other old people, were coming in accompanied by several relatives taking up the waiting area seats so the real patients couldn’t get a seat. It seems that taking granny to hospital is treated as a bit of a family day out.

Digressing again, Funchal Central Hospital is a bit of a tired looking place decor wise, but it was clean, spacious, reasonably maintained, and seemed to have everything it needed, for dealing with me at least.

My last ‘drip’ was completed at around 4pm, but at 7pm I still had the needle sticking out of my arm. I had to ask 3 times to have it removed before someone eventually came and did it. I had said to two staff members during the early afternoon that if I was going to be discharged then I would need assistance to get home, including the use of a wheelchair. It was made pretty clear early on that the objective was to discharge me once a way had been found to deal with the immediate pain, and that relief happened at around 4pm. The ambulance to take me home didn’t arrive to pick me up until nearly 11pm. There was one man who seemed to be in charge of organising this, and for sure he wasn’t using a computerised system, and whether cash passed hands to jump the queue I couldn’t say. But at one time in desperation I wheeled myself out to the ambulance pick up point to plead for the next ambulance out, but this man told me I couldn’t wait outside, and against my will wheeled me back to the A & E waiting area.

Eventually I was told my ambulance was ready, 14 hours after arriving that morning and nearly 7 hours after my treatment and consultations were complete. I bit my tongue throughout and wasn’t rude and didn’t complain, and whether that worked in my favour or not I will never know. Unfortunately I was so late leaving, that the pharmacies were closed and as a result I didn’t get my pain relief medicine until the following afternoon. In the meantime the effects of the injection at around 4pm had long since worn off, so I ended up going home in as much pain as when I had started out that morning. The ambulance staff were excellent though, and wheeled me and then carried me to where I needed to be next to my bed at home.

I have since been told that I will have to pay for the ambulance services that I ‘consumed’ on that day.

 

So, after my 14 hour visit, just to really get an injection and prescription, was I impressed? Not really. I think the facilities are acceptable, and the staff were able, pleasant and accommodating, and the disappointing soup was a minor concern that could be overcome with a little sachet of salt and access to a microwave oven. The lack of attractive staff uniforms were a much greater concern however, as without a pretty nurse or two the whole experience is a total downer, and I don’t think low patient morale is not a good recipe for speedy recovery. The fact that there was only one doctor available is another concern, and makes the department name ‘Urgencies’ somewhat meaningless. The organisation of patients however was totally unacceptable, from the worthless sticker scheme right through to leaving the hospital. But that is what this new computerised system is supposed to address, so perhaps my ‘accident’ just occurred at the wrong time.

Maybe I was just unlucky with my own situation, but I can only reiterate that I was in extreme pain for many hours. To send me home when the only effective pain relief treatment had worn off was unacceptable, and possibly dangerous. Given my circumstances they should have kept me in overnight at least.

Anyway, just to finish up, I would say that I was so glad that my little bit of substandard Portuguese was so useful. Without it I probably couldn’t even have summoned an ambulance, let alone understood what was going on at the hospital, which would otherwise at the very least been confusing, if not even more scary.

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BTW – Snow here again in  the high zones, and Tobi sent in this video link :

http://www.dnoticias.pt/default.aspx?file_id=dn03010101300109

You shouldn’t need to sign in to the Diário website anymore.

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www.madeira4u.com

Aside from your valued blog responses (you can reply direct using the form at the bottom of each blog comments page), please send any unreported Madeira news, topical photos, events information, or snippets for the madeira4u blog to blog@madeira4u.com – anyone can join in! Thank you!

26 thoughts on “Funchal Central Hospital & Madeira’s Medical Care – A Blogger’s Experience”

  1. 6 days later … things aren't much better now, though I can just about get around around at home with a walking stick, painfully … but what are the options on what to do next? Clearly there is not much locally that would be of help, so I would have to go to FCH and risk going through the same routine again. I will have to make that decision by Sunday when my prescription medicine has run out. Anyone got a wheelchair they can lend me so I can go by taxi?

    PS – many thanks to everyone who has sent good wishes and offers of help, but this blog is not about me, just my experiences. You will know I am OK as long as a blog keeps appearing, and if I do miss a day I will put a message on to say so … last Sunday being the exception as I didn't expect to be out for over 16 hours!
    –Der

  2. Your story brings back many memories Der since I spent the best part of a year in FCH. On the bright side, the longer your stay, I can guarantee your Portuguese will improve dramatically and your circle of friends within the locals will increase. Two invaluable words you need- "Doi Muito". At least it usually gets stronger painkillers everytime repeated. Hope your recovery is very quick
    –Don

  3. Sheila and I send our best wishes for a rapid recovery – so sorry to hear you have had such an anxious time.
    Can any one enlighten me as to what happens in the local Clinics. When you have a medical problem, do you get the first doctor available? Do you "sign up" with a particular one? If you need further treatment do you have the same original doctor (if available)?
    Another question I would appreciate help with is about breakdowns on the Via Rapida. Can one use your own breakdown service (from the insurance) or does one have to use the official emergency service?
    –The Other Derek

  4. I've been up in the mountains and seen snow (and the locals making their little snowmen for their cars!), but until yesterday I hadn't seen a blanket of snow on the mountains clearly visible from the Via Rapida as we made our way into Funchal. When's spring coming? – I'm cold!
    –Andrew

  5. I see Tobi is the first to make his contribution in English to the Diário coverage of the snow. I tried but I can't get it to take my comments.

    Thanks Derek, I have been to the Docs a couple of times in the local health centre, and gone straight into the 'urgencies' part, even though nothing was urgent. In that part you just take the duty doctor, but there is another part that deals with appointments, but I haven't had to do that yet. Elaine has more experience than me so maybe she can clarify?

    Re via rapida breakdowns, I think the rescue is free using the emergency number to get you to the nearest garage, and anyway the police will probably spot you before you get in contact. Again someone will need to confirm, as thankfully I haven't had the pleasure yet.
    –Der

  6. Can I ask other blog readers…if anyone has been on holiday (flying from Funchal) to Gran Canaria. I am looking to go in March. Never been to that island…would be grateful for any recommendations for hotels, preferably in Las Palmas. Thanks

    Der how is your back?
    –Sarah

  7. Der i hope you get better soon , but being in the same situation as you , i need to get mine sorted quick as i still need to work , I went to a chiropractor, and they did sort it out , i hope you dont have to do this as it costs but it might only be your last hope.

    Really bad weather today , a large cruise ship just passed sounding its horn, before turning out to sea, i bet they are glad they are leaving.

    The webcam for upstairs hasnt worked since the 25th Jan , must be frozen up , but i hear there were big traffic problems with everyone trying to see the snow , and i would think the police have closed the roads…
    –Tobi

  8. Hi Derek, you should take your residencia form or card to your local health centre and tell them that you are now living in Madeira and wish to register with a family doctor. After answering the usual bureaucratic questions you will be issued with another form called "Cartao Do Utente" (this is a medical card but they are only giving out the paper version at present). You will need to present this form or card every time you go to the clinic, whether it is to make an appointment with either the doctor or a nurse or to just request a prescription. You will also need to present your card at the pharmacy along with your prescription in order to collect your medication (always remember to keep any receipts for tax purposes). You will also need to remember to take any prescrition from your doctor etc back to the reception desk to have the necessary stamps (2) attached, otherwise you you will be turned away from the pharmacy. At time of registration you may be asked to make an assessment appointment with the nurse so that she can record a complete record of your health requirements including dates of ALL inoculations you have received (over here they insist that you keep up with everything including tetanus even though you may have been told in the UK that you no longer need it).
    If your doctor needs to refer you to any type of tests, whether it is blood, urine, mammogram or internal or anything else you can imagine they will give you another form of prescription to take with you, again this must also be taken to reception for the stamps. These stamps also apply to any prescriptions etc issued at FCH.
    Once you are registered it is fairly straight forward to request an appointment, although you will need to explain your needs to the receptionist and you may have to wait several weeks. If you need a same day appointemt you will need to go as early as possible to reception and wait in line, preferably with a ticket although as you probably already know this does not always stop queue jumping, but please always be prepared to wait anyway. I have in the past, waited for 6 hours to see the doctor without a prior appointment and up to 2 hours with one. On one occasion my appointment with a nurse was overlooked completely and I was still sitting waiting when they started to lock up for the evening!
    If you work here you will need to give a doctors certificate if you are ever off sick on a Monday or a Friday or for more than one day during the week and to obtain the certificate you will need to see either your family doctor or the emergency dept doctor at first sign of illness to varify that you are actually sick and unable to attend work (if you are suffering from ANY ailment which might prevent you from getting to them under your own steam then you will need to call an ambulance, however you may be charged for that). There is no self certification here and it is extremely difficult if not impossible to get a doctors certificate at a later date! If you are unlucky enough to have to have a certificate (3 copies) you will then need to take it to the social secuity office to get it logged and stamped etc. One copy is for them to keep, another you give to your employer and the third is for your own records.
    Please don't let any of this put you off, most of the bad experiences I have had happened to me because I did not know what the procedures were and had to find my way in the dark but hopefully you will now be forewarned. Thus far the actual medical treatment I have received has been very thorough, with nothing much left to chance. Although, I have to say I am in total agreement with Der as regards to FCH but that is another story!
    If you do have any dificulty in registering there is a department at a medical centre near to the Windsor Hotel in Funchal where you can take your residencia papers to be registered and you will then be given yet another form to take back to your local health centre.

    Gosh, I could have done a complete blog!
    –Elaine

  9. sorry to hear about your back Der,hope it's improving.
    it's absolutely freezing here in UK,we are in Southampton for the w/end ,been out and about today and with the wind chill factor it feels like minus 7,and a forecast of snow Sun/Mon
    –vic

  10. I have read your blog today Der, not a good position to be in when there are no relatives or friends nearby in an emergency. How about a pyramid cascade system for those foreign residents living in Madeira who can be called in an emergency? Don't know how many peoople that would involve but quite a few I would imagine. Next best thing is to hobble on to Easy Jet back to the UK to get treated. Hope tomorrow goews well for you and you get your painkillers.
    –Viv

  11. If you are resident here you are not entitled to health care on the NHS in the UK. That's one good reason for not jumping on a SleazyJet plane. I can think of others…..
    –Andrew

  12. Oh Dear!
    My little stay at the hospital seems quite a merry trip compared to the Der and Elaine experience.
    Euthanasia would take place after you're dead at that rate.
    –Martin

  13. Hi Sarah
    I flew to Gran Canaria from here about 5 years ago for 4 days, plane journey 55 minutes – hooligans – entire plane except for me and my freind. Were grounded at the airport before embarking on the bus journey to the resort for several hours until life jackets that had been stolen by the said hooligans had been recovered ,,,and yes we have Madeiran HOOLIGANS! Trip from airport to Playas del Ingles made me wish we were back in madeira already as it was like visiting costa del crimo and the landscape was full of rubbish until we hit the built up hotel areas, which Funchal is unfortunately fast approaching (oh, and maybe Porto Santo now as well)! Did pass an Ikea store on the way and got excited for 5 minutes but the only good thing about the place was…fab shopping, Spar supermarkets everywhere and English products and a sand dune with naked people everywhere, oh and drag clubs – great fun! But really why pay to go there when you can fly easy jet back home for the same thing but without the sunny weather! Would suggest a trip to Lisbon, more cultural and moreto see and Sintra is just amazing. Personally Gran Canaria is not a place to go for a nice holiday, it's like going to Spain but with more rubbish in the streets. Saying that it was an experience and a great opportunity to get off the rock and not go back to depressing, cold England! In my opinion Gran canaria and the resorts (not the mounatain areas) is visiting a very dirty UK with a beach and a bit of sun – big dissapointment when you have the fab surroundings and culture of living in Madeira!
    Sorry – thats my opinion.
    –Sam

  14. VIV

    Your idea of Pyramid system or phone a freind is a great idea particularly in a situation as derek had with his trip to the hospital. Whilst reading his expereinces I really thought why didn't he pick up the phone – I or someone else he knew would have helped out and picked him up from the hospital, but ,saying that when on your own here it is difficult to impose on freinds or people that you know, so you just deal with it yourself best way you know how and without wanting to inconvenience anyone (can't spell that word)just in case. Der give me a call about this because maybe with both our websites we could set up something to help readers in the future so that the fantastic expereiences of visting such places such as FCH can be less depressing if we can set up a 'help' system, so no one will have to endure the process alone again and possibly face the thought of eithr dying from the pain or from hunger whilst sat in a wheelchair waiting for a lift home!!!!
    One thing that gets ME most about living away from family and freinds is that when something like this happens you are truly alone, had this been the UK despite the problems with the NHS there is always a freind or member of the family one can call to make the situation less depressing than the situation you find your self in when it happens here.
    –Sam

  15. Glad you agree with me, Sam. I don't live there yet but I am sure that those already living there and those contemplating it would value an informal system like this as a failsafe in an emergency. Good luck with your new site Sam, and I do hope someone on Madeira reading the blog will go and help Der out even if he says he is alright!
    –Viv

  16. thanks everyone, a good day of contributions, and Sam you made me laugh this morning with the hooligan story, and not much of that lately.

    I did say that that blog was about my experience and not about me, and if I gave the impression that I was alone and without help that wasn't my intention and I am sorry. I think I secretly wanted to go through the experience at some time, but with something less painful ( a sort of dry run), and an ambulance this time really was the only option to ensure the correct handling for me and a wheelchair. As for aftercare, it has been offered and gratefully accepted, and much appreciated, but I am quite independent and in situations like this I am best left alone with a mobile phone in case of emergency. At no time I have I felt isolated, my biggest domestic concern today is that the bathroom has not been cleaned for two weeks. Daytime I am now much better, although at night my condition worsens considerably for reasons I can't explain. I have a short term and long term plan to deal with the problem and ensure I don't get this problem again. I am lucky, I really have to hand all the support I need, but it made sense to tell the hospital that I needed help as admission would have been the best short term option for me. Anyway, many thanks to those who have helped, to those who have offered, and those who have sent good wishes.

    If I have made people stop and think about what it would mean for them in a similar situation, then OK you probably didn't jump for joy at the thought, but maybe you will be better off now and more prepared for having done so. A support group for such situations is probably a good idea, but really what needs to be overcome is a language and understanding (how it works) barrier, as if it works for the locals it should work for anyone as long as family / friend support is there.

    –Der

  17. The idea of a support group is very good. To be fair to the Doctors & nurses at the hospital whilst the language is a problem, it is compounded by the fact they do not have the time to commit to working out what the patient is saying if not in Portuguese. During my long stay there, I was regularly wheeled to another ward with the explanation that I had a "friend" that wished to speak to me. This was invariably a foreigner who was having communication problems. One notable example that springs to mind was a very old German lady who had lived on the island for many years and the nurse told me they were worried that she had not eaten since admission (4 days earlier). Since my German is non-existant, patience was the interpreter and the problem was simply that the poor dear was toothless and couldnt eat the solids. Once I spoke to the kitchen staff and they mushed up her food she happily got stuck into it with gusto and pleasingly left the hospital within days.
    –Don

  18. Maybe with the increasing age and medical dependency of the "foreign to Madeira" english speaking and also british residents,together with tourists and visitors it might be worth forming a volunteer TRANSLATOR force.
    Comprising Portuguese/English speakers and also volunteers perhaps able handle to Portuguese to other languages.
    They could be called to help upon when the need arises by the triage or admissions dept at the Hos.
    The english church may find this a worthwhile charity.
    I was lucky and knew a portuguese lady who could help me out when admitted to Hospital.
    I can handle french and german, but know little portuguese, although having being taught latin at school I can understand simple written phrases.
    I can get the gist of spoken portuguese, but constucting a sensible sentence is beyond me.
    It's a shame madeirans don't learn french as a third language then we could have a complete fiasco with my crap french and theirs.
    The wrong leg would be certainly amputated.
    Hope your back gets better soon Der.
    –Martin

  19. Seeing a private doctor may mean that you get a quicker appointment but obviously it costs and even then, once you are in the waiting room you may still have that long wait to contend with.
    At FCH matters are not helped at all because there appears to be such a shortage of doctors in the first place. On one occasion I had an 8.30am outpatients appointment but the doctor for whatever reasons, didn't arrive at the clinic until 11am. I have also found that despite having an appointment, there will always be somebody that comes along and gets slotted in before you, perhaps because they have pleaded their need to the nurse that they have to get back to work or have turned up with their own and everybody else's children who are tired and screaming, knowing that this will help to speed them through.
    I have even arrived at my local health centre at 6.30 to start queuing for a 9am appointment (and even then, there were others already waiting) but as soon as the doors are opened everyone surges in regardless of the fact that some of them have only just arrived or whoever was there before them. I don't think it matters how well prepared you are, just be prepared to wait and try treating it as an entertainment outing as the locals seem to do.
    –Elaine

  20. Hi Sam

    Thanks for the info. I was looking to travel somewhere I hadn't been. I have been to Lisbon and a lot of other cities in Portugal and wanted somewhere warm. Sarah

  21. Wow, incredible weblog structure! How long have you been running a blog for? you make running a blog look easy. The full glance of your web site is wonderful, let alone the content!

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